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Insurance Nurse Reviewer Jobs (NOW HIRING)

Employer paid life insurance * 401K with employer contribution * Wellness program with reward ... By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure ...

The OASIS Reviewer is responsible for analyzing the data integrity and consistency of OASIS ... Current Driver's License, vehicle insurance, and access to a dependable vehicle or public ...

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RN Clinical Reviewer - Jericho or Albany, NY (#25332) * Location: Jericho orAlbany, NY * Employment ... Health Insurance subject to plan eligibility requirements * Work Schedule: Full-time position, 5 ...

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Insurance Nurse Reviewer information

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$37

$42

How much do insurance nurse reviewer jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for insurance nurse reviewer in the United States is $37.04, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $41.35 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Insurance Nurse Reviewer position, and why are they important?

To thrive as an Insurance Nurse Reviewer, you need a current nursing license, clinical experience, and a strong understanding of medical terminology and claims review processes. Familiarity with utilization review software, health insurance claims systems, and URAC or CM certification is often required. Attention to detail, critical thinking, and effective written and verbal communication skills help you excel in this position. These qualifications and abilities are vital for accurately evaluating medical records, ensuring compliance, and making informed decisions regarding healthcare coverage.

What does a typical day look like for an Insurance Nurse Reviewer?

On a typical day, an Insurance Nurse Reviewer spends much of their time reviewing patient medical records, evaluating insurance claims for medical necessity, and documenting their findings in detail. The role often involves collaborating with physicians, case managers, and adjusters to clarify information or seek additional insights when necessary. You may also participate in team meetings to discuss complex cases, ensure adherence to regulatory standards, and stay current with evolving policies. The work is largely independent but requires strong communication skills and a systematic approach to managing multiple cases effectively.

What is an Insurance Nurse Reviewer job?

An Insurance Nurse Reviewer is a licensed nurse who evaluates medical claims to ensure they meet policy guidelines and medical necessity. They review patient records, treatment plans, and healthcare provider documentation to determine coverage eligibility. Their role helps insurance companies manage costs while ensuring patients receive appropriate care. Strong clinical knowledge and attention to detail are essential for assessing claims accurately.

More about Insurance Nurse Reviewer jobs
What cities are hiring for Insurance Nurse Reviewer jobs? Cities with the most Insurance Nurse Reviewer job openings:
What are the most commonly searched types of Insurance Nurse Reviewer jobs? The most popular types of Insurance Nurse Reviewer jobs are:
What states have the most Insurance Nurse Reviewer jobs? States with the most job openings for Insurance Nurse Reviewer jobs include:
Infographic showing various Insurance Nurse Reviewer job openings in the United States as of May 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $77,034 per year, or $37 per hour.
LPN CASE REVIEWER with Security Clearance

LPN CASE REVIEWER with Security Clearance

DAWSON

Pinellas Park, FL

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago


Job description

Licensed Practical Nurse – Temporary Case Reviewer We are seeking a skilled and dedicated Licensed Practical Nurse (LPN) to join our team as a Temporary Case Reviewer (TCR). In this role, you will provide the services of Medical Case Management in support of Individual Medical Readiness to the Army Reserve Medical Management Center (AR-MMC). This role shall provide a wide range of services to Soldiers found to have medical issues or concerns that deem them not medically not ready (MNR) for mobilization/training and require referral management for care/treatment or for applicable medical board.

The TCR will work in conjunction with other healthcare providers, professionals, and non-contract personnel. Responsibilities: The TCR will: * Work collaboratively with the Providers, Registered Nurse Case Manager, and designated military personnel. * Assist in the review process of temporary or permanent P3/4 profiles.

* Contact Soldiers to obtain medical documentation. * Communicate with Command and unit as required. * Manage MNR Soldier’s plan of care from receipt of case referral or notification through case closure, as required.

* Coordinate warm hand off to facilitate continuity of care in the event of case transition between Contractor staff. * Provide entry into the tracking system. * Be familiar with and understand regulations pertinent to managing Soldiers who have medical issues and medical readiness without deviation from standard.

* Educate Soldiers on resources available to improve medical and dental readiness. * Continually seek improvement to increase client satisfaction and develop lasting relationships with client personnel. * Participate in team meetings, trainings, and quality improvement initiatives to enhance decision-making processes and ensure adherence to standards.

Requirements: * Degree: Certificate. * Education: Graduation from a State Board of Nursing approved LPN/LVN training program or completion of equivalent military training that permits sitting for the State licensure examination. * Experience: One year of experience within the last two years as a practical or vocational nurse.

* Licensure: Current, full, active and unrestricted license as a practical or vocational nurse. * Foreign Medical Graduates: Contract workers who are graduates of foreign medical schools will possess both a U.S. medical license and certification by ECFMG for health care physicians and Commission on Graduates of Foreign Nursing Schools (CGFNS for nurses as defined in 29 CFR 825.125.

Knowledge, Skills, and Abilities: Computer skills to enable them to develop working knowledge of Medical Operational Data System (MODS), Medical Protection System (MEDPROS), Medical Readiness Portal, Medical Evaluation Board (MEB) Prep, Joint Legacy Viewer (JLV), Electronic Medical Management Processing System (eMMPS), Integrated Personnel and Pay System (IPPS-A), Personnel Electronic Records Management System (iPERMS), Commander’s Strength Management Module (CSMM), Medical Electronic Data (for) Care History And Readiness Tracking (MEDCHART), and Reserve Health Readiness Program (RHRP) as required for performance of services. You will receive training to use these systems. Must be proficient in Microsoft Word, Excel, PowerPoint, Outlook, and Adobe PDF.

Ability to communicate effectively orally and in writing. Additional requirements include: U.S. Citizenship.

Possess communication and problem solving skills. Strong organizational skills and ability to work independently are also required. Ability to work collaboratively with the Case Management Team and designated military personnel.

WORK SCHEDULE & LOCATION Work hours are typically 0800 – 1700, Monday through Friday, excluding U.S. Federal Holidays. The Government may permit telecommuting (teleworking) when determined to be in the best interest of the Government in meeting work requirements.

Worksite: C. W. Bill Young Armed Forces Reserve Center 2801 Grand Ave.

Pinellas Park, FL 33782 Physical Requirements: - Ability to sit for extended periods while reviewing medical records and reports. - Clear vision and hearing abilities to analyze medical documents and communicate effectively. - Manual dexterity and fine motor skills to navigate computer systems and input data accurately.

Note: Reasonable accommodations may be considered for qualified individuals with disabilities. DAWSON is an Equal Opportunity/VEVRAA federal contractor. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status, or any other characteristic protected by law.

DAWSON offers a best-in-class benefits program including medical, dental, and vision insurance; a 401(k) program with employer match; paid vacation and sick leave; employer-paid basic life and AD&D insurance; an Employee Assistance Program; and a flexible work environment. Additionally, employees can choose from several voluntary benefits including critical illness coverage; accident insurance; identity theft coverage; pet insurance, and more. DAWSON gives preference to internal candidates.

If no internal candidate meets our qualifications, external candidates will be given consideration.